Background Using digital tools to support healthy food choices and access may counteract the negative effects of living in under-resourced communities on diet quality. Objective We aimed to develop and evaluate the psychometric properties of a Digital Food and Nutrition Literacy (DFNL) survey and its association with diet quality for informing future tailored interventions to improve diet quality. Methods The DFNL survey was theory-informed by the Information-Motivation-Behavioral Skills Model and a multi-dimensional model for making healthy food choices online. In this cross-sectional study, 196 adults from a low-income, low food access community in Northeast Connecticut completed an online survey. Principal component analysis was used to identify a DFNL index and components for multivariable linear regression analyses with diet quality, an external variable theoretically expected to be associated with DFNL. Diet quality was assessed using the Short Healthy Eating Index (sHEI) and liking-based Diet Quality Index (DQI). Results The 10-item DFNL index was internally reliable and explained 53.8% of total variance through three interpretable components—online grocery shopping, online nutrition information, and online communication. Associations between DFNL and diet quality varied by DFNL component and diet quality measure; strongest associations were observed for online nutrition information and online grocery shopping components, particularly with adequacy scores of both diet quality measures. Conclusions These preliminary findings support the construct validity of the DFNL index. Assessing DFNL may help identify modifiable behavioral skills in community nutrition interventions that can be tailored to participants’ knowledge gaps and motivation to support diet quality in under-resourced populations. Summary The developed Digital Food and Nutrition Literacy survey showed initial evidence of construct validity. The three component DFNL structure was definable, showing significant associations with diet quality, particularly adequacy scores.
Background The objective of this research was to study the acute consumption of caffeine on the performance of young male soccer players in the Loughborough Soccer Passing Test (LSPT) and Yo-Yo Intermittent Recovery Test Level 1 (YYIR1), and also on the heart rate (HR), blood pressure (BP), and Rate Pressure Product (RPP), immediately after the YYIR1. Method In a randomized, counterbalanced, crossover design, twelve young male soccer players (16.5 ± 0.52 years; 63 ± 8.06 kg; training background 4-5 sessions per week) voluntarily completed two distinct experimental sessions: i) Caffeine and ii) Placebo. In each test session, one hour after taking a caffeine or placebo (flour) capsule (3 mg·kg-1), the participants first completed the LSPT and then the YYIR1.HR, systolic and diastolic blood pressure (SBP and DBP) were measured before the start, one hour after the start, and immediately after the end of the YYIR1. Since the Shapiro-Wilk test confirmed the normality of the data, parametric tests (repeated-measures ANOVA and dependent t-test) were used to analyze the research questions. Results Two-way repeated-measures ANOVA revealed significant main effects of condition (p = 0.006) and time (p < 0.001) for HR, without a significant condition × time interaction (p = 0.144); however, post-hoc analysis showed significantly higher HR following caffeine ingestion compared to placebo immediately after the YYIR1 (p = 0.025). A significant condition × time interaction was observed for DBP (p = 0.014), though pairwise comparisons showed no significant post-hoc differences (all p ≥ 0.101). No significant main or interaction effects were found for SBP or RPP (all p ≥ 0.066). Conclusion Within the limits of the current sample size, acute ingestion of 3 mg·kg-1 caffeine elicited modest physiological responses in adolescent soccer players, significantly augmenting post-exercise HR without substantially altering BP, RPP, or soccer-specific performance factors. However, given the observed numerical improvements in functional test results, these findings should be interpreted cautiously as low-dose caffeine may offer subtle practical benefits that warrant further investigation with greater statistical power.
Background The impact of a diet high in ultra-processed foods (UPF) on mortality risk in patients with cardiovascular disease (CVD) remains unclear. Objective We examined the diet quality of a high UPF diet and its association with risk of total CVD mortality, ischemic heart disease (IHD) mortality, and stroke mortality in post- myocardial infraction (MI) patients. Methods We analyzed data from 4,365 post-MI patients in the Alpha Omega Cohort (79% men). Dietary intake at baseline was collected using a 203-item FFQ. Diet quality was assessed using the Dutch Healthy Diet Index adapted for CVD patients (DHD-CVD, range 0-160). UPF were identified and categorized according to the Nova classification system. Q1 and Q4 of %g/day of UPF represented a low and a high ultra-processed diet, respectively. HRs for CVD, IHD and stroke mortality were obtained from multivariable Cox regression models. Results Mean UPF contribution to the diet was 18%g/day (Q1 vs Q4 = 9 vs 29%g/day). Compared to Q1, patients in Q4 had higher intakes of total energy, and lower intakes of fruit and vegetables. DHD-CVD scores decreased slightly across quartiles (Q1 vs Q4 = 95 vs 82). Over a median follow-up of 14 years, 1,012 patients died from CVD (659 from IHD, 208 from stroke). Compared to Q1, a high ultra-processed diet was not consistently or significantly associated with CVD and IHD mortality. However, it was associated with a higher risk of stroke mortality (HRper10% point increase: 1.21, 95% CI: 1.02-1.42). This association was stronger in older patients, women, and those with a higher BMI, lower physical activity levels, and lower socio-economic status and robust to sensitivity analysis. Conclusions In post-MI patients, a high UPF diet was lower in whole, cardio-protective foods. Our study highlights the adverse association of a high UPF diet with stroke mortality risk among patients that have previously experienced an MI.
Background:Diet quality is a key determinant of healthy aging, yet fully assessing dietary intake remains a challenge partly because of data limitations and difficulty in integrating information from methodologically distinct datasets. Different nationally representative datasets can offer complementary perspectives: the National Health and Nutrition Examination Survey (NHANES) captures self-reported dietary intake using 1 to 2 d of 24-h recall, whereas the Circana Consumer Network (CN) is a national retail dataset that records year-long grocery purchases from ∼60,000 United States households. Objectives:This study aimed to evaluate whether dietary intake reported in NHANES 2017-2018 aligns with food purchase trends in CN 2018 among United States adults aged ≥55 y. Methods:We examined self-reported dietary intake of grocery/store-bought foods from 24-h recalls in NHANES (n = 1950 individuals) and, separately, household grocery purchases from 1- and 2-person households in CN (n = 29,192 households), analyzed by sex and age group (55-64 y, 65-74 y, and 75+ y). For each dataset, healthfulness of food intakes or purchases was assessed using the 2015 Healthy Eating Index (HEI) and food group proportions were evaluated by percent mass (grams) and energy (kilocalorie). Results:Mean total HEI scores were modest and comparable across datasets (NHANES: 55.7 ± 0.9; CN: 51.3 ± 0.1; P = 0.004). Both sources demonstrated moderate agreement among the 13 HEI component scores, revealing consistent shortfalls in total/whole fruit, greens and beans, whole grains, and saturated fat moderation. Food group proportions had <10% difference across most categories by both mass and energy, although there were higher discrepancies for mixed dishes, condiments, and snacks/sweets. Conclusions:In United States adults aged ≥55 y, grocery/store-sourced intake from NHANES and household grocery purchases from CN showed broadly similar but not interchangeable patterns of diet quality, indicating that purchase data can complement, but not replace, recall-based dietary surveillance. Integrating purchase records with recalls could provide deeper insights into older adults' dietary behaviors and strengthen precision nutrition research.
Background Nearly 80% of Americans do not meet recommendations for fruit, an important source of fiber, potassium, and vitamin C. In the 2020-2025 Dietary Guidelines for Americans, the fruit group included whole fruit (fresh, frozen, dried, canned) as well as 100% fruit juice (“juice”). Approximately half of reported fruit intake comes from whole fruit (“fruit”) while the other half comes from juice, sugar-sweetened beverages, and diet beverages. Objective The objective of this study was to investigate whether frequency of fruit or juice intake differs among adults with and without cardiovascular disease (CVD) or CVD risk factors. Methods Data from n=371,038 U.S. adults from the 2019 Behavior Risk Factor Surveillance System was used to identify consumers of fruit and juice, frequency of fruit or juice intake, and those with high blood pressure, elevated blood cholesterol, angina/coronary heart disease (CHD), heart attack, or stroke. Independent sample t-tests and linear regression were utilized to determine whether mean fruit consumption or juice consumption frequency differed between groups with and without CVD or CVD risk factors. Results Fruit consumption frequency was lower in adults who self-reported high blood pressure (p<0.0001), high cholesterol (p<0.0001), heart attack (p<0.0001), CHD (p=0.0020), or stroke (p<0.0001), before and after controlling for age, education, income, and smoking. Juice consumption frequency was higher in adults who self-reported high blood pressure (p<0.0001), heart attack (p<0.0001), CHD (p=0.0166), or stroke (p<0.0001). After controlling for sociodemographic characteristics, significant differences in juice intake frequency remained only for high cholesterol and heart attack. Conclusions Adults with less favorable CVD status reported lower fruit intake frequency and, for some indicators, differences in juice intake frequency. Additional research is warranted to examine how CVD status affects fruit intake frequency, pinpoint potential mechanisms, and identify strategies to increase fruit consumption in the U.S. population.
Background Food-based dietary guidelines (FBDGs) are essential tools for promoting healthy, sustainable diets, yet global adherence is low. Health and nutrition professionals are key to translating these policies into practice, but the factors influencing their implementation efforts remain under-researched. Objective This study aimed to identify factors influencing FBDG implementation from the perspective of health and nutrition professionals and to explore opportunities for strengthening implementation. Methods Using a socio-ecological framework, this study employed an exploratory sequential mixed-methods design. Phase 1 involved 20 qualitative interviews with professionals across six continents. Insights informed Phase 2, a quantitative survey (n = 118) of global professionals. Data were analyzed using deductive content analysis and descriptive statistics. Results While 80.5% of professionals use FBDGs in practice, 57.6% rate them as only "somewhat" or "slightly" helpful in promoting healthy, sustainable food choices. Major barriers include perceived food industry influence (83.0%) and public misinformation. Facilitators include the "plate" visual format (77.1%) and the inclusion of more plant-based options. Critically, professionals advocate for systemic change, identifying fiscal policies—such as subsidies for healthy foods and tax reductions on vegetables and legumes—as essential to address cost barriers and create supportive food environments. Furthermore, inclusive designs that account for diverse cultural and nutritional philosophies are viewed as vital for increasing professional implementation. Conclusions Health and nutrition professionals encounter multiple barriers and facilitators in implementing national FBDGs. Policy makers and scientific committees should address these barriers and leverage facilitators to improve FBDG development and implementation. Findings provide initial valuable insights for future research and policy efforts aimed at promoting healthy and sustainable diets. Statement of Significance This is the first global analysis to explore FBDG implementation through a socio-ecological lens. It uniquely highlights the views of health and nutrition professionals on barriers and facilitators in their daily work and the translation of these guidelines from policy into practice.
Background:The 2025-2030 Dietary Guidelines for Americans emphasize whole, minimally processed foods. However, the time required to prepare these foods may present a barrier. There is limited research on how other responsibilities shape food preparation activities. Objectives:The objective of this study was to identify the daily life activities that adults in the United States consider responsibilities and evaluate the association between the amount of time spent on responsibilities and food preparation activities. Methods:Using data from a national survey among United States adults, we identified which activities adults consider responsibilities. We used the American Time Use Survey and the Eating and Health Module data from 2014-2016 and 2022-2023 to examine the relationship between time spent on responsibilities and food preparation in the pooled sample and stratified by household composition. Results:Households with children spent the most time in responsibilities and food preparation, with single-parent households spending less time in food preparation than dual-parent households. The estimated association between time in responsibilities and food preparation was small but significant and negative in the pooled sample and across household composition subgroups. Conclusions:The marginal association between responsibilities and food preparation time is small, suggesting that households largely protect food preparation time as responsibilities increase. However, cumulative effects across realistic variation in responsibilities are nontrivial (representing ≤9% to 16% of mean food preparation time), and the relative inelasticity itself suggests that many households may already be operating near a minimum feasible level of food preparation time, raising questions about the potential for policies to encourage additional home cooking without simultaneously addressing structural time burdens. The findings provide policy-relevant evidence that time scarcity, beyond individual preferences, is strongly associated with household food preparation decisions, suggesting that it may operate as a meaningful constraint rather than merely reflecting preference differences.
Background The prevalence of women entering pregnancy with overweight or obesity is rising in the United States. The dual burden of undernutrition and overweight or obesity can lead to micronutrient deficiencies. Dietary diversity supports micronutrient adequacy and can be assessed using the Minimum Dietary Diversity for Women of Reproductive Age (MDD-W) a food group-based indicator using 24-hour dietary recall data. Lower dietary diversity may be associated with lower gut microbiome diversity and overall community composition; however, the relationship during pregnancy is unclear. Objective This study aims to (1) describe associations between pre-pregnancy BMI (pBMI) and dietary diversity during pregnancy and (2) investigate whether the pregnancy gut microbiota diversity is associated with dietary diversity. Methods Data were collected from participants in the Michigan Archive for Research on Child Health (MARCH) cohort (n=132, third trimester). Twenty-four-hour dietary recall data were used to assess dietary diversity according to the MDD-W indicator. A subset (n = 114) provided fecal samples for 16S rRNA gene sequencing. Results Based on pBMI, 49% of participants had normal weight, 25% had overweight, and 26% had obesity. Parity, income, and marital status differed significantly across pBMI categories. Overall, 20.5% of participants did not meet the minimum dietary diversity (MDD-W score < 5). pBMI was inversely correlated with MDD-W scores, with women with obesity having lower dietary diversity than women of normal weight. Consumption of low nutrient density foods was similar across pBMI categories. Gut microbiome alpha and beta diversity were not associated with MDD-W. Conclusions Though no associations between the gut microbiota and diet diversity were observed, our results confirm that women with higher pBMI may be at risk of inadequate micronutrient intake. These results emphasize the value of dietary diversity screening and intervention in care for women with higher pBMI, given the well-established role of micronutrients for maternal and fetal health during the third trimester and beyond.
Animal-source foods (ASFs) have long been central to human diets but have come under increased scrutiny in recent years because of relatively large environmental impacts, animal welfare considerations, and some negative health impacts. One option for addressing these issues is (at least partially) replacing ASFs in the diet with alternatives to ASFs (Alt-ASFs): conventional or novel foods with the potential to be consumed as a substitute for conventional ASFs such as meat, eggs, dairy, and fish. However, the adoption of such products at scale depends on consumers purchasing, preparing, and eating them as part of their broader eating practices. This paper undertakes a structured narrative review informed by scoping review methods of consumer acceptability of alternative animal-free sources of serum (Alt-ASFs), separately considering Alt-ASFs made from plants, cells, insects, algae, and fungi. Two databases (Scopus, Google Scholar) were searched, covering articles published from 1 January, 2000 until 24 February, 2024 (the search date). A total of 5998 records were identified, and 61 were included in the full-text synthesis, covering 29 countries. The results show that acceptability varies significantly by Alt-ASF type. Key barriers across all categories include poor sensory qualities (e.g., taste, texture), limited access, high prices, unfamiliarity, and perceived inconvenience. Facilitating factors include perceived health and environmental benefits, though these alone rarely overcome the aforementioned barriers. Plant-based alternatives have the highest acceptance, whereas cell-based and insect-based alternatives have the lowest acceptance, although this varies across cultures and evidence is limited for some contexts. Although plant-based alternatives are often largely seen as merely less desirable due to sensory and convenience factors, cell- and insect-based alternatives may not even be seen as food by many consumers, who may express fear or disgust at eating them. Although food acceptability evolves over time through cultural, commercial, and policy influences, scaling Alt-ASF consumption will require both product improvements and consumer outreach.
Background:Understanding the spatial distribution of nutrient inadequacy is critical for designing context-specific interventions to improve human health. Objectives:The objective of our study was to determine the spatial distribution of inadequate apparent protein, lysine, and tryptophan intake among Malawi's households with children aged <5 y. Methods:We retrieved household consumption and expenditure data for 5952 children aged 6 to 59 mo from Malawi's 2019-2020 Integrated Household Survey under formal consent from the National Statistical Office. Relevant food composition tables and databases were used to estimate protein, lysine, and tryptophan intake based on food items. Using the adult female equivalent matrix, we applied Food and Agriculture Organization thresholds (0.66 g/kg/d protein, 35 mg/kg/d lysine, and 4.8 mg/kg/d tryptophan) to assess adequacy. Household consumption data were processed in R Studio. Median values were used to replace outliers and conversion factors utilized to compute edible portions. The processed data were merged with district shapefiles and subsequently analyzed to generate the spatial distribution of nutrient inadequacy (total and available protein, lysine, and tryptophan). Results:Regional disparities in nutrient inadequacy for total and available protein, lysine, and tryptophan were evident across Malawi, with inadequate available lysine intake being highly prevalent (>40%) in all districts in the Central Region, followed by the Southern Region, where 7 of 13 districts experienced lysine deprivation of >40%. Similarly, inadequate available protein intake was evident in the Central Region, followed by the Southern Region. The Northern Region exhibited the lowest inadequacy for total and available protein, lysine, and tryptophan intake among children. Conclusions:Regional variations in nutrient inadequacy were evident across Malawi, with the Central Region most affected by protein, lysine, and tryptophan inadequacy, followed by the Southern Region, although the Northern Region showed the lowest inadequacy. This highlights the need for region-specific interventions to address protein, lysine, and tryptophan inadequacy among children aged <5 y.
Background:Many dietary guidelines recommend limiting or excluding red and processed meat to promote health and prevent chronic diseases. Objectives:This study investigated associations between white meat-only and vegetarian diets and mortality from all causes, heart diseases, cancers, and stroke. Methods:The American Cancer Society's Cancer Prevention Study-II (CPS-II) cohort participants aged 30 to 95 y at baseline (1982) with mortality data through 2020 were examined (n = 998,378; 45% male, n = 626,017 deaths). A brief diet questionnaire identified meat intake [red/processed meat intake: high (≥6 d/wk); moderate (4 to <6 d/wk); low (0.5 to <4 d/wk); white meat-only; vegetarian]. Cox proportional hazards models adjusted for demographic, lifestyle, and health factors examined associations between diet categories and mortality risk. Effect modification by sex, smoking, BMI, baseline age group, and attained age was examined. Results:Most participants consumed red/processed meat (high = 37%, moderate = 31%, low = 31%; white meat-only = 1%; vegetarian = 0.4%). Compared with high red/processed meat intake, low intake was associated with 1% to 5% lower mortality risk from all causes, heart diseases, and cancers across multiple strata, and 4% lower stroke mortality risk overall [hazard ratio (HR): 0.96; 95% confidence interval (CI): 0.94, 0.99]. White meat-only was associated with 5% to 7% lower all-cause mortality risk among males (HR: 0.93; 95% CI: 0.89, 0.98), individuals with healthy weight (HR: 0.95; 95% CI: 0.91, 0.98), and the 50 to 64 y age group (HR: 0.94; 95% CI: 0.90, 0.97), where results were similar with a vegetarian diet (50-64 y; HR: 0.94; 95% CI: 0.88, 1.00). Among participants reaching age ≥80, white meat-only was associated with lower all-cause (HR: 0.94; 95% CI: 0.91, 0.97) and cancer mortality risk (HR: 0.91; 95% CI: 0.83, 0.99). No other associations were statistically significant. Conclusions:In CPS-II, limiting red/processed meat intake was associated with a small but significantly lower risk of all-cause and cause-specific mortality. Diets excluding red/processed meat may lower risk in certain subgroups, but large studies targeting these diets are needed to elucidate associations with mortality.
Background Consumption of fermented dairy has been associated with favorable cardiometabolic outcomes, but limited data from clinical trials has been available regarding effects of fermented dairy products at differing levels of dairy fat on biomarkers of cardiometabolic health. Objective This randomized, controlled, parallel-arm, 12-week trial evaluated the effect of replacing non-dairy foods with 2 servings/d of either full-fat or low-fat fermented dairy foods on cardiometabolic health biomarkers in adults at risk for adverse cardiometabolic outcomes. Methods Adults with a body mass index (BMI) of 25.0-39.9 kg/m2 and elevated fasting triglycerides (≥120 mg/dL) were randomly assigned to consume study foods provided as either 2 servings/d of full-fat fermented dairy foods, 2 servings/d of low-fat fermented dairy foods, or 2 servings/d of non-dairy control foods, for 12 weeks. Biomarkers of glucose homeostasis, lipid metabolism, inflammation, as well as anthropometrics and vital signs were assessed. Results Mean (SD) age and BMI of the intent-to-treat population (N = 110) were 45.7 (13.5) years and 31.3 (4.28) kg/m2, respectively. Full-fat fermented dairy showed a difference (p = 0.047) for change in least squares geometric mean waist circumference vs. control (-1.62% vs. 2.21%, respectively) with an effect estimate of -4.13% (-7.33, -0.81). No other statistically significant differences were observed, including the primary outcome of Matsuda index of insulin sensitivity [effect estimates of 5.24% (-20.0, 38.5) for low-fat fermented dairy and -3.11% (-26.3, 27.3) for full-fat fermented dairy, respectively, vs. control for difference in percent change in least squares geometric mean]. Conclusion Consumption of full-fat fermented dairy foods for 12 weeks was associated with a small reduction in waist circumference compared to non-dairy foods. No other statistically significant effects of two servings daily of low-fat or full-fat dairy were observed for other biomarkers of cardiometabolic health. Clinical Trial Registry Number NCT04999462 (clinicaltrials.gov)
Children and adolescents in Indonesia are experiencing the Triple Burden of Malnutrition (TBM), resulting from an increasing prevalence of overweight and obesity paired with persistent undernutrition and anemia. The extent to which the COVID-19 pandemic further exacerbated TBM among this group, because of lifestyle changes and increased food insecurity, has not been well-documented. This narrative review aimed to fill that gap by exploring components of TBM (i.e., undernutrition, anemia, overweight and obesity), its determinants (e.g., diet), and related nutrition policies and programs among school-aged children and adolescents in Indonesia, during the pandemic. We reviewed a total of ten peer-reviewed articles published between 2021 and 2025 on children and adolescents’ nutrition status and TBM-related determinants. Results suggested that during COVID-19, children and adolescents in Indonesia experienced a high prevalence of undernutrition, overweight and obesity, and anemia. Most children and adolescents also faced higher levels of food insecurity and lower physical activity. The implementation of online learning halted several school-based nutrition programs, including iron-folic acid supplementation. Nutrition sensitive programs, such as conditional cash transfers and food assistance were poorly distributed and contained processed foods, respectively. Nevertheless, some positive changes were also observed, including innovations in the delivery of nutrition education. Dietary changes were mixed. While some reported a higher consumption of deep-fried foods and snacks, more frequent vegetable consumption and less frequent consumption of sugary drinks were also reported. Future research is needed to understand the mixed findings related to dietary changes and how this contributes to TBM in Indonesia at the national level. Additionally, it is crucial to strengthen children and adolescent nutrition policies and programs that target TBM simultaneously.
Background Understanding inter-individual variation is critical for developing strategies to improve health. Metabolic phenotypes impact how individuals respond to dietary change. While literature has examined response to dietary interventions between metabolic phenotypes, none have yet considered sustainable healthy diets. Objective Exploratory, hypothesis-generating, post-hoc secondary analysis from the MyPlanetDiet randomised controlled trial is used to examine subgroup response to sustainable healthy diets. The aim is to identify metabolic phenotype subgroups (MPs) within the MyPlanetDiet sample population and examine if MPs responded differently to dietary change. Methods The MyPlanetDiet study was a 12-week randomised controlled trial testing the impacts of more sustainable healthy diet advice relative to advice from food-based dietary guidelines. Dietary assessments, fasting serum samples and anthropometry were collected at baseline and endpoint. k-means cluster analysis of baseline serum metabolic health markers identified MPs. Metabolomic profiles, dietary intakes and changes in metabolic health over time were compared between MPs using partial least squares discriminant analysis (PLS-DA) and analysis of covariance (ANCOVA). Results Three distinct MPs were identified with significantly different metabolomic profiles despite comparable baseline dietary intakes. MP1 was categorised as the most metabolically unhealthy, MP2 was mostly female with the lowest anthropometry and high total cholesterol, and MP3 was the youngest with the healthiest blood lipid concentrations. There were significant time*group interactions for total cholesterol (p=0.001), HDL cholesterol (p<0.001), triglycerides (p=0.002) and C-reactive protein (p=0.043) between MPs. Significant decreases in total cholesterol within MP1 (5.92±0.88mmol/L to 5.74±0.83mmol/L, p=0.006) and MP2 (5.81±0.86mmol/L to 5.64±0.94mmol/L, p=0.018) were observed, but no significant difference was observed in MP3 (p=0.146). Increased intakes of fruit and vegetables and whole grains were associated with decreased total cholesterol in MP1 and MP2 (all p<0.05). Conclusion Metabolic phenotyping shows inter-individual variation in metabolic response to dietary change. Metabolic phenotyping could be a valuable tool for informing personalised nutrition strategies to improve diet and metabolic health. Clinical Trial Registry Number Registered with ClinicalTrials.gov on February 21, 2022, Registration ID: NCT05253547 (https://clinicaltrials.gov/study/NCT05253547)
Background:Nutritional preload strategies can improve postprandial glycemic control through modulation of incretin secretion. We previously identified specific collagen peptides (CP; Nextida GC) that stimulate glucagon-like peptide-1 (GLP-1) secretion in vitro and improve postprandial glycemic responses in preclinical models and a pilot human study. Objectives:This study aims to investigate the effects of a CP preload on postprandial glycemic control and to characterize the associated hormonal and physiological responses in participants with normoglycemia or prediabetes. Methods:In a randomized, double-blind, placebo-controlled, crossover study, 30 participants (12 normoglycemic and 18 prediabetic) ingested 10 g CP or placebo 30 min before a standardized carbohydrate-rich meal (preload phase). Plasma glucose, serum insulin, C-peptide, GLP-1, and glucose-dependent insulinotropic polypeptide (GIP) concentrations were measured during the preload and postprandial periods. As a potential physiological mechanism, gastric transit was assessed via the gastric residence time of an indigestible capsule. Results:During the preload phase, CP significantly increased insulin and incretin levels (GLP-1 and GIP) compared with placebo (all P < 0.0001). After the meal, CP significantly reduced postprandial glucose excursions (incremental area under the curve (iAUC)0-180 min, P = 0.0178), whereas total insulin responses were unchanged (iAUC-30-180 min, P = 0.8929). Furthermore, CP prolonged the gastric residence time of the indigestible 3D-Transit capsule in the prediabetic subgroup (P = 0.0436). Conclusions:A 10 g preload of CP improved postprandial glycemic control without increasing overall postprandial insulin exposure. These effects were accompanied by early stimulation of insulin and incretin hormones and, in individuals with prediabetes, prolonged gastric residence time. The findings suggest that CP may support healthy postprandial metabolic regulation through complementary hormonal and physiological mechanisms.This study was registered at clinicaltrials.gov as NCT06789263.
Background:Premenstrual and menstrual symptoms arise in response to cyclical hormonal fluctuations and encompass psychological and physical manifestations that may significantly impair quality of life. Treatment options are limited, demonstrate inconsistent efficacy, and are associated with notable adverse effects. There is growing interest in evidence-based nutritional approaches, with several placebo-controlled trials demonstrating that certain nutrient supplements significantly alleviate menstrual-cycle-related symptomatology. Objectives:This single-arm pilot study aims to evaluate self-reported changes in premenstrual and menstrual symptoms in females taking a novel multinutrient supplement containing saffron extract, chamomile extract, essential minerals (chromium, magnesium, zinc, iron), vitamins (D, B6, C), and- omega-3 (n-3) fatty acids, using advanced encapsulation technology. Methods:Forty females (mean age: 33 y) with premenstrual and menstrual symptoms consumed the supplement daily for 3 consecutive menstrual cycles. The validated Menstrual Symptom Questionnaire (MSQ) and a 5-point severity rating scale evaluated symptoms at baseline and after each menstrual cycle. Results:Overall MSQ scores decreased significantly from baseline to cycle 1 (P = 0.0028), cycle 2 (P < 0.0001), and cycle 3 (P < 0.0001). Overall symptom severity scores decreased by a mean 50.42% from baseline to cycle 3 (2.58 ± 0.65 to 1.28 ± 0.83, P < 0.0001), corresponding to a change from distracting (moderate-severe) to barely noticeable. There were significant improvements in all measured individual physical and psychological symptoms from baseline to cycle 3 (all P < 0.0001). By cycle 3, 88% of participants agreed that the supplement reduced symptom severity, and 82% agreed that the supplement reduced symptom duration. Conclusions:These findings suggest that this novel multinutrient supplement may be of interest as a nutritional approach to support females throughout the menstrual cycle, warranting further investigation in randomized, placebo-controlled trials.This trial was registered on clinicaltrials.gov as NCT07267728.
Background:Low birth weight (LBW) increases the risk of developing metabolic disorders in adulthood and reduces fatty acid (FA) brain accretion in offspring in rodent models. As milk composition is partially influenced by maternal diet, it is conceivable to act on maternal diet to improve FA brain accretion and development in offspring. Objectives:The study aimed to evaluate the impact of n-3 long-chain polyunsaturated FA (LCPUFA) deficiency or enrichment in the maternal diet during gestation and lactation on maternal diet on milk composition, offspring brain lipids, and the potential to counterbalance the effects of a high-fat diet (HFD). Methods:We investigated the influence of n-3 LCPUFA-deficient and -enriched maternal diets, as well as HFD challenge, on key aspects of offspring development, including birth weight, milk and brain FA composition, glucose and lipid metabolism outcomes, and general behavior in male and female offspring from a rat model of maternal protein restriction. Results:Maternal n-3 LCPUFA-deficient diet leads to discernible alterations both in mother red blood cell (RBC) membranes, milk, and offspring brain, impacting critical FAs such as α-linolenic acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). The exact opposite effect is observed with a maternal EPA-, DHA-, and arachidonic acid (AA)-enriched diet. DHA, n-3 LCPUFA, and the n-6/n-3 ratio in maternal RBC membrane are identified as offspring-predicting brain FA composition. An n-3-deficient maternal diet clearly impacts metabolic health, in particular hepatic lipid metabolism, and general motor activity of the offspring later in life in a sex-dependent manner. Providing an EPA-DHA-AA-enriched diet during gestation and lactation partially normalized these parameters. Conclusions:Our findings demonstrate that maternal n-3 LCPUFA deficiency disrupts offspring brain FA composition and metabolic health, whereas an EPA-DHA-AA-enriched diet during gestation and lactation partially restores these alterations, highlighting the potential of maternal dietary intervention to mitigate long-term developmental and metabolic risks in LBW offspring, in particular after HFD challenge.
Background:Food insecurity (FI) is associated with lower physical activity (PA) and higher cardiometabolic risk. Food Is Medicine (FIM) interventions increasingly demonstrate improvements in diet quality and FI, yet little is known about perceived PA barriers and facilitators within these interventions. Objectives:To examine perceived barriers and facilitators to PA among adults experiencing FI during participation in a randomly assigned FIM intervention, with attention to the role of community health worker (CHW) coaching and factors shaping PA capacity. Methods:This qualitative study was embedded within the Healthy Food First randomized clinical trial among adults with hypertension and FI, in which participants were assigned to food support (produce delivery or grocery subsidy) with or without CHW lifestyle coaching. Semi-structured telephone interviews were conducted at 12 mo or 18 mo, depending on intervention duration. Transcripts were analyzed inductively using constant comparison. Themes were organized across 3 domains: PA engagement, CHW coaching experience, and health and PA context. Results:Interviews with 38 participants, most of whom were female (66%) and Black (53%), indicated that PA was important for health and quality of life. Motivation to remain active was common. Sustained engagement was constrained by time scarcity, fatigue, occupational demands, environmental safety concerns, weather, health complication history, and financial limitations. Social connection and access to PA-friendly environments were key facilitators. Occupational PA varied widely; physically demanding work often limited leisure-time PA. CHW support was viewed as encouraging, but a stronger emphasis on diet than PA constrained its influence on PA engagement. Participants also described bidirectional links between diet quality, energy, and capacity for PA. Conclusions:Among adults experiencing FI, motivation for PA was high, but engagement was constrained by contextual and capacity barriers. PA support within FIM interventions appears acceptable and warrants testing using more explicit, low-burden approaches delivered alongside nutrition-focused components.This trial was registered at clinicaltrials.gov as NCT05048836.
